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Electrical brain responses during processing of nociceptive stimuli around the detection threshold

Berfelo, T. (2019) Electrical brain responses during processing of nociceptive stimuli around the detection threshold.

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Abstract:Multiple threshold tracking (MTT) has been shown to be effective in measuring the effect of stimulus parameters on stimulus detection. In addition, the evoked potential (EP) has been shown to reflect neurophysiological activity related to stimulus processing. Therefore, a combination of both techniques, known as the MTT-EP experiment, is a promising diagnostic method which may provide objective insight into the processing of nociceptive stimuli. Stimulus-related EPs were recently investigated using the MTT-EP experiment in pain-free subjects at the University of Twente, but its applicability has not been explored yet in a hospital environment and in chronic pain patients. Firstly, therefore, we explored the replicability of the MTT-EP experiment in twenty pain-free subjects at St. Antonius Hospital. Secondly, we observed the neurophysiological responses during processing of nociceptive stimuli around the detection threshold in seven failed back surgery syndrome (FBSS) patients. Results show that (initial) NDTs and EPs present profiles and phenomena (such as habituation and paired-pulse facilitation), which are in line with results from the University of Twente. Also, it is seen that the EP is rather modulated by stimulus detection, amplitudes and the number of received stimuli. Strikingly, we found higher NDTs in FBSS patients, in whom we assumed they suffered from a central sensitization syndrome (CSI-score = 49.0), comparing to results of pain-free subjects (CSI-score = 14.6). These NDTs in FBSS patients may implicate that additional facilitating effects occurred in the central nervous system. However, the influence of analgesics is uncertain. Additionally, an early phase component of the EP was found at CPzA1A2 for detected stimuli, which might indicate that it can be a potential biomarker of brain processing in FBSS patients. Since similar phenomena in NDTs and EPs were observed during nociceptive stimulation in pain-free subjects at St. Antonius Hospital, it can be concluded that results of MTT-EP experiment can be replicated. Secondly, since an altered behavior of NDTs and EPs seems to be observed in FBSS patients compared to pain-free subjects, it is recommended to continue this study in these chronic pain patients.
Item Type:Essay (Master)
Clients:
St. Antonius Hospital Nieuwegein, Nieuwegein, The Netherlands
Faculty:TNW: Science and Technology
Subject:44 medicine, 50 technical science in general
Programme:Technical Medicine MSc (60033)
Link to this item:http://purl.utwente.nl/essays/77717
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